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Primary care practices share PQRI experience
e-Reports, February 22, 2010
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Responding to a callout, primary care practices that received incentive pay through the Physician Quality Reporting Initiative (PQRI) contacted the ISMA. The specialty practice experience with PQRI was discussed in the Jan. 25 ISMA Reports (see here).

Some credit EHR for success
For primary care practices, the most important element for success with PQRI appears to be an electronic health record (EHR). “If we did not have our EHR system, I don’t think we could participate in the PQRI program,” said Janie Kramer, office manager for the solo practice of James Rice, D.O., in Mount Vernon. “But with our system, it all can be done at the click of a button.”

The practice, with a patient load of about 15-20 percent Medicare, determined to capture PQRI data on diabetic patients – consistently among the patient mix. Other measures identified for reporting were flu and pneumonia vaccinations and osteoporosis measures.

“I use a ‘cheat sheet’ as I go through each claim and add the measure before I submit the claim,” said Kramer, who noted the practice staff would never choose to go back to paper records.

Dr. Rice’s office collected PQRI bonus pay of:

  • $622 for half of 2007
  • $1,200 for all of 2008 – doubling the amount

“Every little bit counts,” noted Kramer, who advised practices starting PQRI to attend a seminar to learn the basics. This practice also receives several hundred extra dollars per year from Medicare Advantage plans for PQRI participation. Kramer is willing to answer your questions; call her at (812) 838-3730.

Yes, PQRI participation was worth the effort, said Pamela Cawood, who managed the Pediatric & Internal Medicine Center in Richmond before its recent purchase by Reid Hospital.

The practice of five or six physicians also uses an EHR. Cawood believes practices can still participate if they do not have an EHR – though the technology makes it easier.

The Richmond medical center’s PQRI efforts netted bonus dollars of:

  • $1,500 for half of 2007
  • $3,000 for all of 2008

Cawood advised, “Capture data on at least four measures and do e-prescribing; it’s pretty simple now.” She added, “The most confusing part is checking to make sure you got paid for everything. Give special attention to the IACS portion when you register to review your reports.”

Cawood, who now works for Reid Hospital, also agreed to answer questions about her experience with PQRI. Contact her at 765-935-8926 or pamela.cawood@reidhospital.org.

Making it work on paper
The office of family practice physician Joseph Kacmar, M.D., with one doctor and seven staff members, succeeds with PQRI without an EHR. The staff captures data on four to five measures to be sure they get good data on the minimum three measures. Any incentive earned is used to pay bonuses to staff.

Like Dr. Rice’s office, the Crown Point office of Dr. Kacmar earned:

  • $1,500 for half of 2007
  • $3,000 for all of 2008

“We use a color-coded sheet of paper on the charts,” explained Office Manager Barbara Kacmar. The practice does billing in-house, but Kacmar explained, “The system does not enter the data for you.”

Is it worth the effort? “It’s kind of a pain,” quipped Kacmar, “and it adds more work.” But the staff members participate because they want to become accustomed to reporting. “If we must start reporting on more issues later, we’ll be used to collecting data and it will not be as difficult for us down the road,” explained the office manager.

Douglas Morrell, M.D., a solo family medicine physician from Rushville, advised that he participated in PQRI last year through one of 32 qualified registries for PQRI data. Dr. Morrell has three employees and an EHR in his office.

“I participated last year on the diabetes module thru the American Board of Family Medicine (ABFM) and haven't heard anything yet,” said Dr. Morrell. The ABFM registry indicated successful completion for Dr. Morrell, but he should not expect any bonus payment until fall.

Find plenty of educational tools on PQRI here.

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